This invention relates to apparatus and methods for the treatment of conditions including obstructive sleep apnea (OSA) and snoring. The invention is believed also to relate to the treatment of other upper respiratory conditions.
OSA is the medical condition where the airway becomes partially or fully occluded during sleep in the region of the oro- or hypopharynx. It is a progressive condition that is recognised amongst middle or older aged overweight men, although it is by no means uncommon amongst women and younger people, including adolescents, children and infants. There have been many papers published discussing the medical consequences of OSA and associated syndromes on a person""s well being. The pathophysiological cause of OSA remains the subject of some dispute.
The preferred clinical treatment for OSA is Continuous Positive Airway Pressure (CPAP) which acts to alleviate the occurrence of apneas and hypopneas during sleep. CPAP is the technique of pneumatically splinting the airway open by supplying air at a pressure elevated above atmospheric pressure to the nose, or to the nose and mouth. It is not, however, a curative treatment.
Surgical techniques are also known, however they are radical treatments that have generally been disappointing as a curative.
The inventor, a specialist orthodontist, believes a root cause of OSA can be maxillary constriction leading to excessive or increased nasal airway resistance and mouth breathing, necessitating mouth opening. Maxillary constriction is but one cause of excessive nasal airway resistance. Both this and the low tongue position, associated with the narrowness of the hard palate, result in further postural changes and airway obstruction, leading to snoring and with swallowing problems, to sleep apnea.
The inventor further believes conditions such as certain forms of asthma and upper respiratory tract infections can be attributed to or exacerbated by reduced nasal air conditioning, mouth breathing and low tongue position caused by increased nasal airway resistance. Further, swallowing problems can be attributed to excessive mouth breathing consequent to increased nasal airway resistance, resulting in postural changes. Yet further, cot death can be attributed to postural changes caused by increased nasal airway resistance, resulting in swallowing difficulties. These are conditions that hitherto have not been connected with mouth breathing caused by increased nasal airway resistance.
FIG. 1 is a flow diagram of the progression and interrelationships leading to snoring and sleep apnea from maxillary constriction.
The nasal airway is to be understood as the airway formed between the choanae and the nares.
It is an object of the invention to provide a curative, or at least an ameliorative treatment for conditions including OSA and snoring resulting from excessive nasal airway resistance.
The present invention discloses a method for the treatment of obstructive sleep apnea and/or snoring resulting from maxillary constriction, the method comprising the steps of:
identifying an individual that suffers from at least one condition selected from the group consisting obstructive sleep apnea and snoring;
separating the intermaxillary suture of the individual; and
maintaining the separation until a gap formed thereby is occupied by new bone growth and an intermaxillary suture is reformed, resulting in an increased nasal airway volume and hence a reduction of nasal airway resistance.
The invention further discloses a method for the treatment of obstructive sleep apnea and/or snoring comprising the steps of:
identifying an individual that suffers from at least one condition selected from the group consisting obstructive sleep apnea and snoring;
securing an expansion device to cause orthopaedic displacement of the opposed sides of the upper jaw of the individual to achieve separation of the intermaxillary suture; and
maintaining the separation until the gap formed thereby is occupied by new bone growth and an intermaxillary suture is reformed.
Advantageously, the method further comprises the step of surgically performing a partial corticotomy of the buccal surfaces of the maxillae with or without extension to the piriform aperture or the pterygomaxillary fissure in conjunction with the step of expanding.
Preferably, the expansion device is secured to one or more of the posterior teeth on opposed sides of the upper jaw.
The invention further discloses an implement when used for the treatment of obstructive sleep apnea and/or snoring resulting from excessive nasal airway resistance, the implement comprising means for attachment to the posterior upper jaw at opposed locations and means for causing orthopaedic movement of the upper jaw to cause separation of the intermaxillary suture, and means for maintaining the separation until a stable intermaxillary suture is formed, thereby reducing nasal airway resistance.
Preferably, the attachment means is releasably engageable with the upper jaw. In one preferred form the attachment means secure to one or more of the teeth. In a yet further preferred form the implement is a rapid maxillary expansion device.
The invention further discloses a method for the treatment of the adverse pathophysiological effects of mouth breathing resulting from maxillary constriction, the method comprising the steps of:
expanding the maxilla; and
maintaining the maxillary expansion until a stable state of the maxilla is established.
The invention yet further discloses a method for the treatment of obstructive sleep apnea and/or snoring comprising the steps of:
identifying an individual that suffers from at least one condition selected from the group consisting obstructive sleep apnea and snoring;
laterally expanding the maxillae of the individual; and
maintaining the maxillary expansion until a stable state of the maxilla is established.
The invention yet further discloses a method for the treatment of obstructive sleep apnea and/or snoring comprising the steps of:
identifying an individual that suffers from at least one condition selected from the group consisting obstructive sleep apnea and snoring;
laterally distracting the maxillae of the individual; and
maintaining the distraction until a stable state of the maxillae is established.